Phenobarbital: functions, dosage, side effects, how to use

What Drug Phenobarbital?

What is Phenobarbital for?

Phenobarbital is a drug with a function to control seizures. Controlling and reducing seizures will allow you to do more of your day-to-day activities, reduce your risk of harm when you lose consciousness, and reduce your risk for conditions that may be life-threatening to you as a result of frequent recurring seizures. Phenobarbital is in the anticonvulsant / hypnotic barbiturate classification. This drug works by controlling the abnormal electrical activity in the brain that occurs during a seizure. This medication is also used for a short time (usually no more than 2 weeks) to help calm you down or help you sleep when you have anxiety. These drugs work by affecting certain parts of the brain for the purpose of calming.

Phenobarbital dosage and side effects of phenobarbital are described further below.

How to take Phenobarbital?

Take this medication by mouth before or after food, usually once daily before bed to control seizures, or as directed by your doctor. Take this medicine with food or milk to prevent stomach upset. If you are using the drug in liquid form, measure the dose carefully using a special gauge. Don't use a household spoon, as you may not get the correct dosage.

The dosage is based on your medical condition, your blood levels of Phenobarbital, and your response to treatment. The dosage in children may also be based on their body weight.

Your doctor may direct you a low dose first and gradually increase your dose to prevent side effects such as drowsiness and dizziness. Follow the doctor's instructions carefully. Do not take this drug more or less than the prescribed dose.

It may take several weeks for the best properties and completely control your seizures. This drug works best when the dosage amount is at a constant level. Therefore, take this medicine every day at the same time.

Do not stop taking this medication (and other anticonvulsant drugs) without consulting your doctor. You may make it worse or cause very severe seizures that are difficult to treat (status epilepticus) if this drug suddenly stops.

This medicine may cause a withdrawal reaction, especially if it has been used regularly for a long time or in high doses. In such cases, withdrawal symptoms (such as anxiety, hallucinations, twitching, trouble sleeping) may occur if you suddenly stop using this medicine. Phenobarbital Sakaw can be severe and includes seizures and (rarely) death. To prevent this, the doctor may reduce the dose gradually. Consult your doctor or pharmacist for more details, and report any rejection reactions immediately.

Along with its benefits, this drug may be addictive, although rare. This risk may increase if you have abused alcohol or drugs in the past. Take this medication exactly as prescribed to reduce your risk of addiction.

If this medicine is used for a long time to reduce anxiety or to help you sleep, it may not work very well. Phenobarbital should only be used for a short time to reduce anxiety or aid sleep. Talk with your doctor if this medication stops working well.

Tell your doctor if your anxiety or seizures worsen (for example, the number of seizures increases).

How is Phenobarbital stored?

This medication is best stored at room temperature, away from direct light and damp places. Don't keep it in the bathroom. Don't freeze it. Other brands of this drug may have different storage rules. Observe the storage instructions on the product package or ask your pharmacist. Keep all medicines away from children and pets.

Do not flush medicines down the toilet or down the drain unless instructed to do so. Discard this product when it has expired or when it is no longer needed. Consult your pharmacist or local waste disposal company about how to safely dispose of your product.

Phenobarbital dosage

The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before starting treatment.

What is the Phenobarbital dosage for adults?

Usual adult dose for sedation

Oral, IV, or IM: 30 to 120 mg / day orally in 2 to 3 divided doses.

Maximum 400 mg / day.

Preoperative sedation: 100 to 200 mg IM 60 to 90 minutes before surgery.

Usual Adult Dose for Insomnia

Oral: 100 to 200 mg with a maximum of 400 mg / day.

IM or IV: 100-320 mg with a maximum duration of 2 weeks.

Usual Adult Dose for Seizures

Status epilepticus:

IV dose: 10-20 mg / kg; may repeat the dose every 20 minutes as needed (maximum total dose: 30 mg / kg)

Further Dose of Anticonvulsants: Oral or IV

(Note: the follow-up dose is usually started 12 hours after the initial dose):

1 to 3 mg / kg / day in 1 to 2 divided doses

What is the dosage of Phenobarbital for children?

Usual dose for children for seizures

Status epilepticus:

IV loading dose:

Neonatal: 15 to 20 mg / kg in single or divided doses; may repeat doses of 5 to 10 mg / kg every 15 to 20 minutes as needed (maximum total dose: 40 mg / kg). Note: Respiratory support may be needed to maximize dosage.

Follow-up dose: Oral, IV: 3-4 mg / kg / day given once a day; the follow-up dose is usually started 12 hours after the dose; assess serum concentration; increased to 5 mg / kg / day if needed (usually by the second week of therapy).

Neonatal Abstinence Syndrome:

Loading Dose (optional):

IV: 16 mg / kg as a single dose; followed by a follow-up dose 12 to 24 hours after the initial dose or:

Oral: 16 mg / kg divided into 2 doses and given every 4 to 6 hours; followed by a follow-up dose 12 to 24 hours after the dose.

Follow-up dose: Oral or IV: Initial: 5 mg / kg / day divided every 12 hours; adjust crew dosage according to abstinence values ​​and serum concentrations; Dosage required: 2-8 mg / kg / day. After the patient is stable, reduce the Phenobarbital dose so that the drug concentration is reduced by 10% to 20% per day.

Anoxic neuroprotectant injury (with or without refrigeration): IV: 40 mg / kg once;

Status epilepticus:

Dosage: IV:

Infants and Children: Initial: 15 to 20 mg / kg (maximum: 1000 mg / dose); may repeat the initial dose after 15 minutes if needed (maximum total dose: 40 mg / kg). Note: additional respiratory support may be required, to maximize dosage.

Maintenance dose of anticonvulsants: Oral, IV: Note: the follow-up dose is usually started 12 hours after the dose:

Infants: 5-6 mg / kg / day in 1 to 2 divided doses

Children:

1 to 5 years: 6-8 mg / kg / day in 1 to 2 divided doses

5 to 12 years: 4-6 mg / kg / day in 1 to 2 divided doses

Adolescents 12 years or older: 1 to 3 mg / kg / day in 1 to 2 divided doses

Children's Dose for Anesthetics

Children:

Sedation: Oral: 2 mg / kg / dose 3 times a day

Preoperative sedation: Oral, IM, or IV: 1 to 3 mg / kg 1 to 1.5 hours before procedure

Children's Dosage for Insomnia

Children:

Hypnotic: IM or IV: 3-5 mg / kg at bedtime

Children's Dose for Hyperbilirubinemia

Less than 12 years: 3-8 mg / kg / day orally in 2 to 3 divided doses

Maximum dose: 12 mg / kg / day

In what dosage is Phenobarbital available?

Tablets: 15 mg; 30 mg; 100 mg

Elixir: 20 mg / 5 mL

Phenobarbital side effects

What side effects can be experienced due to Phenobarbital?

Phenobarbital can cause a severe allergic reaction. Stop taking Phenobarbital and seek emergency medical help if you have any of the following signs of an allergic reaction: hives; hard to breath; swelling of your face, lips, tongue, or throat.

Call your doctor if you experience any of these serious side effects:

• Restless muscle movements in your eyes, tongue, jaw, or neck
• Slow heart rate, shallow breathing
• Dizziness, fainting
• Fever or sore throat
• Sores in your mouth
• Easy bruising or bleeding; or
• Rupture of blood vessels under your skin

Other side effects include

• Drowsiness and dizziness
• Problems with memory or concentration
• Excited, irritable, aggressive, or confused (especially in children or older adults)
• Loss of balance or coordination
• Nausea, constipation
• Headache; or
• The "hangover" effect (drowsiness the day after taking the drug)

Not everyone experiences this side effect. There may be some side effects not listed above. If you are concerned about the side effects please consult your doctor or pharmacist.

Phenobarbital Drug Warnings and Cautions

What should be known before using Phenobarbital?

Before using certain drugs, consider the risks and benefits first. This is a decision you and your doctor will have to make. For this drug, pay attention to the following:

• If you are pregnant, planning to become pregnant, or are breastfeeding
• If you are taking prescription or nonprescription drugs, herbs, or dietary supplements
• If you have an allergy to drugs, food, or other substances
• If you have depression, have suicidal tendencies, have a history of substance abuse
• If you have problems with liver or respiratory disease
• If you feel pain or shock

Is Phenobarbital safe for pregnant and lactating women?

There is no adequate research on the risks of using this drug in pregnant or breastfeeding women. Always consult your doctor to weigh the potential benefits and risks before using this medication. This drug is included in the risk of pregnancy category D according to the US Food and Drug Administration (FDA).

The following references the pregnancy risk categories according to the FDA:

• A = Not at risk
• B = No risk in several studies
• C = May be risky
• D = There is positive evidence of risk
• X = Contraindicated
• N = Unknown

For Breastfeeding

Phenobarbital is absorbed into human milk in small amounts. However, because the drug absorption time in newborns is usually longer, Phenobarbital accumulation may occur and the neonatal serum level of the infant can potentially exceed the maternal serum level. Babies with this condition are reported to have lethargy even as if they were given sedatives. The American Academy of Pediatrics classifies Phenobarbital as a drug that has "caused significant effects in some nursing infants and should be given to nursing mothers with caution". Some researchers have recommended close monitoring of the baby's blood concentration if a breastfeeding mother is to take Phenobarbital.

Phenobarbital Drug Interactions

What medicines may interact with Phenobarbital?

Some DRUGS MAY INTERACT with Phenobarbital. Tell your doctor if you are taking other medications, especially any of the following:

• Sodium oxybate (GHB), stiripentol, or valproic acid as they can increase the risk of these Phenobarbital side effects
• Methoxiflurane and the risk of side effects can increase if you also take Phenobarbital
• Beta-adrenergic blockers (eg, propranolol), clozapine, corticosteroids (eg, hydrocortisone), digitoxin, doxycycline, estrogen, imatinib, metronidazole, oral contraceptives (eg, norethindrone / ethinyl estradiol), quinidine, theophyllines, vorikonazole they might get dropped by Phenobarbital

Can food or alcohol interact with Phenobarbital?

Certain drugs should not be used with meals or when eating certain foods because drug interactions can occur. Consuming alcohol or tobacco with certain drugs can also cause interactions to occur. Discuss your use of drugs with food, alcohol, or tobacco with your health care provider.

What health conditions can interact with Phenobarbital?

Any other health conditions you have can affect the use of this drug. Always tell your doctor if you have other health problems.

Phenobarbital overdose

What should I do in an emergency or overdose?

In case of an emergency or overdose, contact the local emergency services provider (112) or immediately to the nearest hospital emergency department.

Overdose symptoms may include:

• Uncontrollable movements of the eyes
• Loss of coordination
• Sleepy
• Breath slows down
• Decrease in body temperature
• Blisters on the skin

What should I do if I miss a dose?

If you forget a dose of this medicine, take it as soon as possible. However, when it is nearing the time of the next dose, skip the missed dose and return to the usual dosing schedule. Don't double the dose.